Relationship between serum CC-16, MCP-1 level and disease severity and prognosis in patients with acute respiratory distress syndrome

Objective To observe the changes of serum clara cell protein-16 (CC-16) and monocyte chemotaxis protein-1 (MCP-1) level in patients with acute respiratory distress syndrome (ARDS) and to explore their relationship with the disease severity and prognosis of ARDS. Methods One hundred and fourteen patients with ARDS who were admitted to Changzhi People′s hospital from January 2017 to March 2018 were selected as the subjects.They were divided into mild group (n=37), moderate group (n=41) and severe group (n=36) according to the severity of ARDS.Sixty healthy persons in out-patient examination were selected as control group.The survival situation of patients in 4 weeks were recorded, the patients were divided into survival group (n=65) and death group (n=49) according to their survival situation.The age, gender, body mass index (BMI), smoking history, acute physiology and acute physiology and chronic health evaluation II (APACHE II) score, sequential organ failure assessment (SOFA) score, serum CC-16 and MCP-1 level were analyzed in each group.The relationship between serum CC-16, MCP-1 level and disease and prognosis of patients with ARDS were analyzed. Results With the increase of disease severity, APACHE II score, SOFA score and serum CC-16, MCP-1 level in patients with ARDS were significantly increased.The differences were statistically significant (F=1 216.886, 1 339.247, 290.879, 417.262; all P=0.000). The APACHE II score, SOFA score and serum CC-16, MCP-1 levels in the death group were (22.13±2.47) scores, (15.09±1.97) scores, (23.85±4.27) μg/L, (36.64±5.21) ng/L respectively, which were significantly higher than those in the survival group (18.25±2.35) scores, (13.23±2.03) scores, (17.34±4.13) μg/L, (27.93±4.88) ng/L, the differences were statistically significant (t=8.538, 4.905, 8.211, 9.146; all P=0.000). Pearson correlation analysis showed that there was a positive correlation between serum CC-16 level and MCP-1 level in patients with ARDS(r=0.589, P=0.000). Meanwhile, the CC-16, MCP-1 were positive correlation with APACHE II score, SOFA score and mortality (CC-16: r=0.504, 0.549, 0.472; P=0.000, 0.000, 0.012; MCP-1: r=0.493, 0.528, 0.435; P=0.006, 0.000, 0.025). APACHE II score (OR=3.083, 95%CI: 0.025-1.364, P<0.05), CC-16 (OR=5.403, 95%CI: 0.011-6.561, P<0.05) and MCP-1 (OR=2.892, 95%CI: 0.034-1.619, P<0.05) were all closely related to ARDS death.CC-16 independent detection, MCP-1 independent detection and the two combined detection predicted the under-curve area, sensitivity and specificity of ARDS patients with in 4 weeks were 0.830, 82.35% and 72.16%; 0.719, 79.25% and 72.19%; 0.866, 85.06% and 80.72% respectively. Conclusion CC-16, MCP-1 are abnormally high expression in serum of patients with ARDS, and its levels are closely related to the severity and prognosis of patients with ARDS.CC-16 combined with MCP-1 detection has high diagnostic value for patients with ARDS, which can be used as an effective index to judge the disease and prognosis of patients with ARDS. Key words: Acute respiratory distress syndrome; Clara cell secretory protein-16; Monocyte chemotaxis protein-1; Disease condition; Prognosis